| NPI | 1790144152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 372500000X Chore Provider |
| 372600000X Adult Companion | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2016-02-14 |
| Last Update Date | 2016-03-08 |