| NPI | 1467917799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 376J00000X Homemaker |
| 385H00000X Respite Care | |
| 3747A0650X Technician, Attendant Care Provider | |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2026-09-09 |