| NPI | 1356004709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child |
| Additional Taxonomies | 251E00000X Home Health |
| 374U00000X Home Health Aide | |
| 385H00000X Respite Care | |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2022-01-31 |