| NPI | 1881308757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker (Licence: FL RN9440999) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL RN9940999) |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2023-01-05 |