| NPI | 1285024877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: AK 293586) |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2023-01-18 |