| NPI | 1306637079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant |
| 172A00000X Driver | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2025-05-13 |
| Last Update Date | 2025-08-13 |