| NPI | 1811593007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 372500000X Chore Provider | |
| 376J00000X Homemaker | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2020-12-11 |
| Last Update Date | 2020-12-14 |