| NPI | 1518420207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2022-11-22 |