| NPI | 1548137615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: WA HMCC.HM.70027488) |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider (Licence: WA NAR.NA.70015256) |
| 3747P1801X Technician, Personal Care Attendant (Licence: WA NAR.NA.70015256) | |
| Enumeration Date | 2025-10-22 |
| Last Update Date | 2025-10-22 |