| NPI | 1841065901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| 347C00000X Private Vehicle | |
| 372600000X Adult Companion | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2024-02-14 |