| NPI | 1922841758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 251J00000X Nursing Care |
| 374U00000X Home Health Aide | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2024-06-18 |
| Last Update Date | 2024-06-18 |