| NPI | 1790445294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 251E00000X Home Health |
| 253Z00000X In Home Supportive Care | |
| 372600000X Adult Companion | |
| Enumeration Date | 2021-12-23 |
| Last Update Date | 2021-12-23 |