| NPI | 1649073685 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant | 
| Additional Taxonomies | 376J00000X Homemaker | 
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2025-03-27 | 
| Last Update Date | 2025-03-27 |