| NPI | 1932097300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 251X00000X Supports Brokerage |
| 253Z00000X In Home Supportive Care | |
| 311Z00000X Custodial Care Facility | |
| 372600000X Adult Companion | |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-06-25 |