| NPI | 1407508948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: GA 057-R00-17) |
| Additional Taxonomies | 251E00000X Home Health (Licence: GA 057-R-0017) |
| 253Z00000X In Home Supportive Care (Licence: GA 057r0017) | |
| 374U00000X Home Health Aide (Licence: GA 057-R-0017) | |
| Enumeration Date | 2022-01-26 |
| Last Update Date | 2023-05-31 |