| NPI | 1225634439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 10041601) |
| Enumeration Date | 2020-12-11 |
| Last Update Date | 2026-04-17 |