| NPI | 1972304863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 172A00000X Driver |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 347C00000X Private Vehicle | |
| 372600000X Adult Companion | |
| 3747P1801X Technician, Personal Care Attendant | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2025-03-24 |
| Last Update Date | 2025-03-24 |