| NPI | 1194483875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 372500000X Chore Provider |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2021-11-30 |
| Last Update Date | 2021-11-30 |