| NPI | 1063577682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician Personal Care Attendant (Licence: AR 32903) |
| Additional Taxonomies | 177F00000X Lodging (Licence: AR 101) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2024-12-27 |