| NPI | 1356950877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: MD A00148616) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: DC NA0000811534) |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2020-07-30 |