| NPI | 1669052965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC HHA15741) |
| Enumeration Date | 2021-04-11 |
| Last Update Date | 2024-04-11 |