| NPI | 1568989705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 347C00000X Private Vehicle |
| Additional Taxonomies | 172A00000X Driver |
| 225700000X Massage Therapist | |
| 251E00000X Home Health | |
| 372500000X Chore Provider | |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2022-07-21 |