| NPI | 1184022402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider (Licence: AZ CNA1000021850) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: AZ ALTP0019) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-18 |