| NPI | 1306765565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 251E00000X Home Health |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2026-07-13 |
| Last Update Date | 2026-07-13 |