| NPI | 1528404233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 374U00000X Home Health Aide |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2023-03-21 |