| NPI | 1215763883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician Personal Care Attendant |
| Additional Taxonomies | 372600000X Adult Companion |
| 374700000X Technician | |
| 3747A0650X Technician Attendant Care Provider | |
| 374U00000X Home Health Aide | |
| 385H00000X Respite Care | |
| Enumeration Date | 2024-09-11 |
| Last Update Date | 2024-09-11 |