| NPI | 1659117018 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant | 
| Additional Taxonomies | 376J00000X Homemaker | 
| 372500000X Chore Provider | |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2024-07-05 | 
| Last Update Date | 2024-07-05 |