| NPI | 1689963704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 372600000X Adult Companion |
| Additional Taxonomies | 372500000X Chore Provider |
| 172V00000X Community Health Worker | |
| 171WH0202X Contractor, Home Modifications | |
| 172A00000X Driver | |
| 374K00000X Religious Nonmedical Practitioner | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2011-04-11 |