| NPI | 1831842723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: PA 63403601) |
| Additional Taxonomies | 385H00000X Respite Care (Licence: PA 63403601) |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2022-01-31 |