| NPI | 1740107762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider |
| Additional Taxonomies | 347C00000X Private Vehicle |
| 3747P1801X Technician, Personal Care Attendant | |
| 376J00000X Homemaker | |
| Enumeration Date | 2026-07-01 |
| Last Update Date | 2026-07-21 |