| NPI | 1861075657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| 347C00000X Private Vehicle | |
| 376J00000X Homemaker | |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2021-04-30 |