| NPI | 1306670476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251E00000X Home Health |
| 253Z00000X In Home Supportive Care | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2024-08-29 |
| Last Update Date | 2024-08-29 |