| NPI | 1376028944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: GA 067-r-1624) |
| Additional Taxonomies | 372600000X Adult Companion (Licence: GA 067-r-1624) |
| 3747P1801X Technician, Personal Care Attendant (Licence: GA 067-r-1624) | |
| 372500000X Chore Provider (Licence: GA 056-r-1624) | |
| 374U00000X Home Health Aide (Licence: GA 067-r-1624) | |
| Enumeration Date | 2018-09-30 |
| Last Update Date | 2018-09-30 |