| NPI | 1902383136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 174200000X |
| 253Z00000X In Home Supportive Care | |
| 372600000X Adult Companion | |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2022-02-04 |