| NPI | 1285276568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: TX 016097) |
| Additional Taxonomies | 251J00000X Nursing Care (Licence: TX 016097) |
| 253Z00000X In Home Supportive Care (Licence: TX 016097) | |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: TX 016097) | |
| 347C00000X Private Vehicle (Licence: TX 016097) | |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2019-10-08 |