| NPI | 1265079347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172A00000X Driver |
| Additional Taxonomies | 374U00000X Home Health Aide |
| 376J00000X Homemaker | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2019-12-08 |
| Last Update Date | 2019-12-08 |