NPI | 1699543892 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 251S00000X |
Additional Taxonomies | 253Z00000X In Home Supportive Care |
261QA0600X Clinic/Center, Adult Day Care | |
Enumeration Date | 2023-12-18 |
Last Update Date | 2023-12-18 |