| NPI | 1093213282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: VA HCO-181029) |
| Additional Taxonomies | 372600000X Adult Companion (Licence: VA HCO-181029) |
| 376K00000X Nurse's Aide (Licence: VA HCO-181029) | |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2018-01-23 |