| NPI | 1205307501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide |
| Additional Taxonomies | 372600000X Adult Companion |
| 372500000X Chore Provider | |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| 385H00000X Respite Care | |
| Enumeration Date | 2018-12-11 |
| Last Update Date | 2018-12-11 |