| NPI | 1467010389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: PA 38643601) |
| Additional Taxonomies | 372600000X Adult Companion (Licence: PA 38643601) |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2019-06-05 |