| NPI | 1497582316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: MN 10832685) |
| Additional Taxonomies | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| 311500000X Alzheimer Center (Dementia Center) | |
| 314000000X Skilled Nursing Facility | |
| Enumeration Date | 2024-09-16 |
| Last Update Date | 2024-09-16 |