| NPI | 1285105940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 364SH0200X Clinical Nurse Specialist, Home Health (Licence: NV 2105320033) |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2019-08-05 |