| NPI | 1225623903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: CO NA00720741) |
| Additional Taxonomies | 172A00000X Driver (Licence: CO 921047101) |
| 174H00000X Health Educator (Licence: CO 147827) | |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2024-04-30 |