| NPI | 1467080754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: NC HC5385) |
| Additional Taxonomies | 385H00000X Respite Care (Licence: NC HC5385) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2020-03-31 |