| NPI | 1154891877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant (Licence: GA 404144) |
| Additional Taxonomies | 372600000X Adult Companion (Licence: GA 404144) |
| 374U00000X Home Health Aide (Licence: GA 404144) | |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2018-11-26 |