| NPI | 1427869304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant (Licence: NM NM222384130E) |
| Additional Taxonomies | 374U00000X Home Health Aide |
| Enumeration Date | 2025-01-18 |
| Last Update Date | 2025-01-18 |