| NPI | 1760169270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 372600000X Adult Companion | |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2023-06-28 |