| NPI | 1154190239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 376J00000X Homemaker |
| 172A00000X Driver | |
| 372600000X Adult Companion | |
| Enumeration Date | 2023-12-29 |
| Last Update Date | 2025-10-10 |