| NPI | 1912544578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: PA 45803601) |
| Additional Taxonomies | 372500000X Chore Provider |
| 372600000X Adult Companion | |
| 376J00000X Homemaker | |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2019-12-03 |