| NPI | 1417827254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: ID PTE365) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2025-11-07 |
| Last Update Date | 2025-11-07 |