| NPI | 1396168548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: NM 374U0000X) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: NM 171M0000X) |
| 225X00000X Occupational Therapist (Licence: NM 225X0000X) | |
| 235500000X Specialist/Technologist (Licence: NM 23550000X) | |
| 172A00000X Driver | |
| Enumeration Date | 2014-01-23 |
| Last Update Date | 2014-02-05 |