| NPI | 1164235313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 171WH0202X Contractor, Home Modifications (Licence: CA 933970) |
| 171WV0202X Contractor, Vehicle Modifications | |
| Enumeration Date | 2025-01-30 |
| Last Update Date | 2025-01-30 |