| NPI | 1356211536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ND R51930) |
| 164W00000X Licensed Practical Nurse (Licence: ND L17403) | |
| Enumeration Date | 2025-11-11 |
| Last Update Date | 2025-11-11 |