| NPI | 1033656616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic |
| Additional Taxonomies | 376J00000X Homemaker |
| 376K00000X Nurse's Aide | |
| 146N00000X Emergency Medical Technician, Basic | |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2023-07-05 |