| NPI | 1144146283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 225700000X Massage Therapist |
| 347C00000X Private Vehicle | |
| 376J00000X Homemaker | |
| Enumeration Date | 2026-06-24 |
| Last Update Date | 2026-06-24 |