| NPI | 1700688629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 374U00000X Home Health Aide |
| 376K00000X Nurse's Aide | |
| 385H00000X Respite Care | |
| Enumeration Date | 2025-03-24 |
| Last Update Date | 2025-03-24 |