| NPI | 1457106676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 347C00000X Private Vehicle |
| 3747P1801X Technician Personal Care Attendant | |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| Enumeration Date | 2024-04-22 |
| Last Update Date | 2024-04-22 |