| NPI | 1811323660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 171W00000X Contractor |
| 253Z00000X In Home Supportive Care | |
| 251J00000X Nursing Care | |
| 3747P1801X Technician, Personal Care Attendant | |
| 251X00000X | |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2017-03-22 |