| NPI | 1487808689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: ND 21153) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: ND 21153) |
| 374U00000X Home Health Aide (Licence: ND 21153) | |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2008-11-14 |