| NPI | 1407278708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: GA 374U00000X) |
| Additional Taxonomies | 372600000X Adult Companion (Licence: GA 372600000X) |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2014-01-06 |