| NPI | 1407539497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 372500000X Chore Provider |
| Additional Taxonomies | 171W00000X Contractor |
| 172A00000X Driver | |
| 225800000X Recreation Therapist | |
| 374U00000X Home Health Aide | |
| 372600000X Adult Companion | |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-08-08 |