| NPI | 1871989723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant (Licence: TX 017169) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2019-01-28 |