| NPI | 1891579215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 374U00000X Home Health Aide |
| 251E00000X Home Health | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2023-08-24 |
| Last Update Date | 2023-08-24 |