| NPI | 1578367801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 172A00000X Driver |
| 251X00000X Supports Brokerage | |
| 253Z00000X In Home Supportive Care | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 376J00000X Homemaker | |
| Enumeration Date | 2025-04-03 |
| Last Update Date | 2025-04-03 |