| NPI | 1669335691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: TX 024525) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: TX 024525) |
| 251E00000X Home Health (Licence: TX 024525) | |
| Enumeration Date | 2025-12-05 |
| Last Update Date | 2025-12-05 |