| NPI | 1508517152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 133N00000X Nutritionist |
| 172A00000X Driver (Licence: AK 7422271) | |
| 372500000X Chore Provider | |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2022-01-14 |