| NPI | 1184039695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide |
| Additional Taxonomies | 172A00000X Driver |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| 376G00000X Nursing Home Administrator | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2014-06-23 |