| NPI | 1457077711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 372600000X Adult Companion |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2022-10-18 |