| NPI | 1073119640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: TX 020255) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: TX 020255) |
| 372600000X Adult Companion (Licence: TX 020255) | |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2020-12-16 |