| NPI | 1205060043 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2009-05-07 |