| NPI | 1740977107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 376J00000X Homemaker |
| 385H00000X Respite Care | |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2025-03-13 |