| NPI | 1770014342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: FL 234735) |
| Additional Taxonomies | 372500000X Chore Provider (Licence: FL 234735) |
| 372600000X Adult Companion (Licence: FL 234735) | |
| 376J00000X Homemaker (Licence: FL 234735) | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-03-24 |