| NPI | 1821567066 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 372600000X Adult Companion | 
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant | 
| 376J00000X Homemaker | |
| Enumeration Date | 2018-11-16 | 
| Last Update Date | 2018-11-16 |