| NPI | 1275422537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: NE 169045) |
| Additional Taxonomies | 3747P1801X Technician Personal Care Attendant |
| Enumeration Date | 2025-07-01 |
| Last Update Date | 2025-07-01 |