| NPI | 1457173130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker | |
| 172A00000X Driver | |
| 174200000X Meals | |
| 174400000X Specialist | |
| 372500000X Chore Provider | |
| Enumeration Date | 2024-10-24 |
| Last Update Date | 2024-10-24 |