| NPI | 1477022317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: MN 394396) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: MN 387743) |
| 372600000X Adult Companion (Licence: MN 387743) | |
| 3747P1801X Technician, Personal Care Attendant (Licence: MN 387743) | |
| 374U00000X Home Health Aide (Licence: MN 387743) | |
| 376J00000X Homemaker (Licence: MN 387743) | |
| 376K00000X Nurse's Aide (Licence: MN 387743) | |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2021-03-31 |