| NPI | 1326642588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant (Licence: ND 1479270) |
| Additional Taxonomies | 385H00000X Respite Care (Licence: NC 1479270) |
| Enumeration Date | 2020-11-27 |
| Last Update Date | 2020-11-27 |