| NPI | 1356011837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: SC IHCP-1558) |
| Additional Taxonomies | 251J00000X Nursing Care (Licence: SC IHCP-1558) |
| 372600000X Adult Companion (Licence: SC IHCP-1558) | |
| 385H00000X Respite Care (Licence: SC IHCP-1558) | |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2021-10-04 |