| NPI | 1669879920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider |
| Additional Taxonomies | 372500000X Chore Provider |
| 372600000X Adult Companion | |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2014-12-01 |