| NPI | 1992504922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: NC HC7767) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: NC HC7767) |
| Enumeration Date | 2025-03-11 |
| Last Update Date | 2025-03-20 |