| NPI | 1336271329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: LA 1584827) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: LA 1584894) |
| 376K00000X Nurse's Aide (Licence: LA 1456462) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2007-07-08 |