| NPI | 1316587918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747A0650X Technician Attendant Care Provider |
| Additional Taxonomies | 172A00000X Driver |
| 372600000X Adult Companion | |
| 374700000X Technician | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2020-01-10 |