| NPI | 1629676523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 376J00000X Homemaker |
| 347C00000X Private Vehicle (Licence: OH HAX3510) | |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2020-10-13 |