| NPI | 1558117390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 172A00000X Driver |
| 310400000X Assisted Living Facility | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2024-04-24 |
| Last Update Date | 2024-04-24 |