| NPI | 1366173874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 372600000X Adult Companion | |
| 376K00000X Nurse's Aide | |
| 385H00000X Respite Care | |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2022-06-23 |