| NPI | 1619380466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 372500000X Chore Provider | |
| 372600000X Adult Companion | |
| 3747A0650X Technician, Attendant Care Provider | |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2022-11-21 |