| NPI | 1447951603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 174H00000X Health Educator |
| 374U00000X Home Health Aide | |
| 171M00000X Case Manager/Care Coordinator | |
| 172A00000X Driver | |
| Enumeration Date | 2023-03-14 |
| Last Update Date | 2023-03-14 |