| NPI | 1952644130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 372600000X Adult Companion (Licence: GA 114376) |
| Additional Taxonomies | 372500000X Chore Provider (Licence: GA 114376) |
| 374U00000X Home Health Aide (Licence: GA 114376) | |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2013-04-05 |