| NPI | 1962294330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 251E00000X Home Health |
| 332U00000X Home Delivered Meals | |
| 372600000X Adult Companion | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2025-05-20 |
| Last Update Date | 2025-05-28 |