| NPI | 1679461156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| 385H00000X Respite Care | |
| 376K00000X Nurse's Aide | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 172A00000X Driver | |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-06-25 |