| NPI | 1316434897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374700000X Technician (Licence: AZ S5Y5K3Y2) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: AZ CNA1000018178) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2023-06-01 |