| NPI | 1649031873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 342000000X Transportation Network Company |
| Enumeration Date | 2024-01-16 |
| Last Update Date | 2024-02-20 |