| NPI | 1336866169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376J00000X Homemaker (Licence: IL 3001932) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: IL 3001932) |
| 376J00000X Homemaker (Licence: IL INH2202079) | |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2022-10-24 |