| NPI | 1417752080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 385H00000X Respite Care |
| 385H00000X Respite Care (Licence: NE 207RH0002X) | |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-02-17 |