| NPI | 1740679885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172A00000X Driver |
| Additional Taxonomies | 372500000X Chore Provider |
| 376J00000X Homemaker | |
| 372600000X Adult Companion | |
| 3747A0650X Technician, Attendant Care Provider | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2016-11-16 |