| NPI | 1316712060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 385H00000X Respite Care | |
| Enumeration Date | 2023-11-21 |
| Last Update Date | 2023-11-21 |