| NPI | 1427753623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider (Licence: MD 225412240494) |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2024-08-27 |