| NPI | 1164244760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2024-10-26 |
| Last Update Date | 2024-10-26 |