| NPI | 1831968585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: VA 0001304164) |
| 251S00000X | |
| 253Z00000X In Home Supportive Care | |
| 314000000X Skilled Nursing Facility | |
| 261QR0208X Clinic/Center, Radiology, Mobile | |
| 313M00000X Nursing Facility/Intermediate Care Facility | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 342000000X Transportation Network Company | |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2023-12-21 |
| Last Update Date | 2023-12-21 |