| NPI | 1427338227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: CT NA9988812) |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider (Licence: CT NA9988812) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2011-08-24 |