| NPI | 1508540501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 251E00000X Home Health |
| 251G00000X Hospice Care, Community Based | |
| 251T00000X Program of All-Inclusive Care for the Elderly (PACE) Provider Organization | |
| 311500000X Alzheimer Center (Dementia Center) | |
| 372600000X Adult Companion | |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2023-06-22 |