| NPI | 1295538015 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: NV 883414) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: AZ CNA1000054992) |
| Enumeration Date | 2025-03-28 |
| Last Update Date | 2025-03-28 |