| NPI | 1760178313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver |
| Additional Taxonomies | 171W00000X Contractor |
| 251E00000X Home Health | |
| 342000000X Transportation Network Company | |
| 347C00000X Private Vehicle | |
| 347E00000X Transportation Broker | |
| 372500000X Chore Provider | |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2023-04-17 |