| NPI | 1659721348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant (Licence: GA 063-R-1309) |
| Additional Taxonomies | 376K00000X Nurse's Aide |
| 372600000X Adult Companion | |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2016-06-14 |