| NPI | 1235431891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: FL 178494) |
| Additional Taxonomies | 372600000X Adult Companion (Licence: FL 258751) |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker (Licence: FL 2875414) | |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2010-12-02 |