| NPI | 1689423667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 251X00000X |
| 253Z00000X In Home Supportive Care | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2024-05-14 |