| NPI | 1770365447 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2023-10-18 |
| Last Update Date | 2023-10-18 |