| NPI | 1477301489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 372600000X Adult Companion (Licence: MN 40644L4021) |
| Additional Taxonomies | 251E00000X Home Health (Licence: MN 40644L4021) |
| 374U00000X Home Health Aide (Licence: MN 40644L4021) | |
| 376J00000X Homemaker (Licence: MN 40644L4021) | |
| Enumeration Date | 2024-05-07 |
| Last Update Date | 2024-05-07 |