| NPI | 1750972659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: NC HC5797) |
| Additional Taxonomies | 372600000X Adult Companion (Licence: NC HC5797) |
| 385H00000X Respite Care (Licence: NC HC5797) | |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2021-02-02 |