| NPI | 1962293191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider |
| 3747P1801X Technician, Personal Care Attendant | |
| 2472E0500X Technician, Other, EEG | |
| 251E00000X Home Health | |
| 246RP1900X Technician, Pathology, Phlebotomy | |
| 251F00000X Home Infusion | |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| Enumeration Date | 2025-05-15 |
| Last Update Date | 2025-05-15 |