| NPI | 1407471337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: TX 311896) |
| 253Z00000X In Home Supportive Care | |
| 376J00000X Homemaker | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2020-06-16 |