| NPI | 1295574556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 372500000X Chore Provider |
| 372600000X Adult Companion | |
| 373H00000X Day Training/Habilitation Specialist | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2024-05-24 |
| Last Update Date | 2024-05-24 |