| NPI | 1437825775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AL 2-051364) |
| Additional Taxonomies | 372500000X Chore Provider |
| 372600000X Adult Companion | |
| 3747A0650X Technician, Attendant Care Provider | |
| 3747P1801X Technician, Personal Care Attendant | |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2021-08-17 |