| NPI | 1871975219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: NV 1710058573) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: NV 1017014744001) |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2018-03-17 |