NPI | 1164963823 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 374U00000X Home Health Aide |
Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: WV 2322-1967) |
374U00000X Home Health Aide (Licence: WV 2322-1967) | |
Enumeration Date | 2017-03-14 |
Last Update Date | 2017-03-14 |