| NPI | 1417840224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 172A00000X Driver (Licence: FL P24-646-96-200-0) |
| 251E00000X Home Health | |
| Enumeration Date | 2025-05-30 |
| Last Update Date | 2025-05-30 |