| NPI | 1376034348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: CA 7516084757) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: MI B8163x) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-05-24 |