| NPI | 1316827280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider |
| Additional Taxonomies | 385H00000X Respite Care |
| 376J00000X Homemaker | |
| Enumeration Date | 2025-09-03 |
| Last Update Date | 2025-09-03 |