| NPI | 1508755380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider |
| Additional Taxonomies | 171WH0202X Contractor, Home Modifications |
| 172V00000X Community Health Worker | |
| 3747P1801X Technician, Personal Care Attendant | |
| 376J00000X Homemaker | |
| Enumeration Date | 2025-06-28 |
| Last Update Date | 2025-07-02 |