| NPI | 1104687466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: GA RN282083) |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-01-23 |