| NPI | 1285127910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376K00000X Nurse's Aide |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy |
| 246W00000X Technician, Cardiology | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-06-07 |