| NPI | 1679900161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker (Licence: FL 235276) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 385H00000X Respite Care (Licence: FL 235276) | |
| 372600000X Adult Companion (Licence: FL 235276) | |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2018-06-29 |