NPI | 1174863013 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: DC LPN1008955) |
Additional Taxonomies | 374U00000X Home Health Aide |
Enumeration Date | 2013-02-28 |
Last Update Date | 2021-07-27 |