| NPI | 1275202665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2021-09-09 |