| NPI | 1942753587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 251B00000X Case Management |
| 251E00000X Home Health | |
| 251S00000X | |
| 305S00000X Point of Service | |
| 372600000X Adult Companion | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2016-09-12 |