| NPI | 1659224244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant (Licence: PA 89103601) |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider (Licence: PA 89103601) |
| 374U00000X Home Health Aide (Licence: PA 89103601) | |
| Enumeration Date | 2026-02-16 |
| Last Update Date | 2026-02-16 |