| NPI | 1427675891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 347E00000X Transportation Broker |
| 374U00000X Home Health Aide | |
| 385H00000X Respite Care | |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2020-07-01 |