| NPI | 1962246785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251J00000X Nursing Care |
| Additional Taxonomies | 251E00000X Home Health |
| 310400000X Assisted Living Facility | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2024-06-25 |
| Last Update Date | 2024-07-01 |