| NPI | 1578456521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 376J00000X Homemaker |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2025-05-29 |
| Last Update Date | 2025-05-29 |