| NPI | 1235620394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: FL CNA-345984) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: FL CNA345984) |
| 251E00000X Home Health (Licence: FL CNA345984) | |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-05-24 |