| NPI | 1386526424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant (Licence: WY 56713) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: CO NA.00833852) |
| Enumeration Date | 2025-07-21 |
| Last Update Date | 2025-07-21 |