| NPI | 1497532758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251T00000X PACE Provider Organization |
| 342000000X Transportation Network Company | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 374U00000X Home Health Aide | |
| 385H00000X Respite Care | |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2023-11-07 |