| NPI | 1215706353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant (Licence: 3747P1801X) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2024-01-01 |
| Last Update Date | 2024-01-05 |