| NPI | 1083388748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: GA PHCP01651) |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: GA PHCP010651) |
| 164W00000X Licensed Practical Nurse (Licence: GA PHCP010651) | |
| 251J00000X Nursing Care (Licence: GA PHCP010651) | |
| 253Z00000X In Home Supportive Care (Licence: GA PHCP010651) | |
| 372600000X Adult Companion (Licence: GA PHCP010651) | |
| 376K00000X Nurse's Aide (Licence: GA PHCP010651) | |
| 385H00000X Respite Care (Licence: GA PHCP010651) | |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2021-08-05 |