| NPI | 1265349849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: TN 228664) |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy (Licence: TN 228664) |
| Enumeration Date | 2026-08-27 |
| Last Update Date | 2026-08-27 |