| NPI | 1295448991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2022-12-28 |
| Last Update Date | 2022-12-28 |