| NPI | 1477142057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2021-01-18 |