| NPI | 1326788399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider (Licence: IN 300048645) |
| Additional Taxonomies | 374U00000X Home Health Aide |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2022-03-29 |