| NPI | 1215302575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant (Licence: PA 27813601) |
| Additional Taxonomies | 372600000X Adult Companion |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2015-12-10 |