| NPI | 1598431215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251J00000X Nursing Care (Licence: GA PHCP011195) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: GA PHCP011195) |
| Enumeration Date | 2021-08-22 |
| Last Update Date | 2021-09-15 |