| NPI | 1144548744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MS A034616) |
| 376K00000X Nurse's Aide (Licence: MS A034616) | |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2021-10-27 |