| NPI | 1386172906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 372500000X Chore Provider |
| 372500000X Chore Provider (Licence: FL AHCHA) | |
| 372600000X Adult Companion (Licence: FL FL19650) | |
| 373H00000X Day Training/Habilitation Specialist | |
| 3747A0650X Technician, Attendant Care Provider | |
| 3747P1801X Technician, Personal Care Attendant | |
| 376J00000X Homemaker | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2022-07-21 |