| NPI | 1376281006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 172A00000X Driver |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2024-02-19 |