| NPI | 1164820007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant (Licence: TX 016544) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: TX 016544) |
| 376J00000X Homemaker (Licence: TX 016544) | |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2014-12-09 |