| NPI | 1568165629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376G00000X Nursing Home Administrator |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-03-27 |