NPI | 1366013039 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: NC HC6102) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NC HC6102) |
385HR2065X Respite Care, Respite Care, Physical Disabilities, Child (Licence: NC HC6102) | |
Enumeration Date | 2021-07-05 |
Last Update Date | 2021-07-22 |