| NPI | 1467264879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2025-01-22 |
| Last Update Date | 2025-01-22 |