| NPI | 1407497241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician Personal Care Attendant |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 3747A0650X Technician Attendant Care Provider | |
| 376J00000X Homemaker | |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2019-10-02 |