| NPI | 1790455152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 374U00000X Home Health Aide |
| 376J00000X Homemaker | |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2021-09-16 |