| NPI | 1285458059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: IN 24-018125) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 172A00000X Driver | |
| Enumeration Date | 2024-11-08 |
| Last Update Date | 2024-11-08 |