| NPI | 1558720599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: SC IHCP-0092) |
| Additional Taxonomies | 372600000X Adult Companion (Licence: SC IHCP-0092) |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2016-02-18 |