| NPI | 1386510089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: NV NV20171612517) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: NV NV20171612517) |
| 374U00000X Home Health Aide (Licence: NV NV20171612517) | |
| Enumeration Date | 2025-10-11 |
| Last Update Date | 2025-10-11 |