| NPI | 1043719818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV CHW1-5465) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2023-08-31 |