| NPI | 1144048182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 172A00000X Driver |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 376J00000X Homemaker | |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2024-09-30 |