| NPI | 1558879189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC HHA13410) |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2024-09-15 |