| NPI | 1568262525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 372500000X Chore Provider |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| Enumeration Date | 2025-03-18 |
| Last Update Date | 2025-03-18 |