| NPI | 1629712591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 376J00000X Homemaker | |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2022-04-26 |