| NPI | 1962616391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 372500000X Chore Provider (Licence: TX 010335) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: TX 010335) |
| 376J00000X Homemaker (Licence: TX 010335) | |
| 251E00000X Home Health (Licence: TX 010335) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2024-08-01 |