| NPI | 1437793304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: PA 41643601) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: PA 41643601) |
| 372600000X Adult Companion (Licence: PA 41643601) | |
| 376J00000X Homemaker (Licence: PA 41643601) | |
| 376K00000X Nurse's Aide (Licence: PA 41643601) | |
| 385H00000X Respite Care (Licence: PA 41643601) | |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2019-11-04 |