| NPI | 1679373385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 372500000X Chore Provider |
| 3747A0650X Technician, Attendant Care Provider | |
| Enumeration Date | 2025-03-13 |
| Last Update Date | 2025-03-13 |