NPI | 1679765754 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 376K00000X Nurse's Aide (Licence: IN 31-01-07-04508) |
Additional Taxonomies | 374U00000X Home Health Aide (Licence: IN 31-03-07-01542) |
Enumeration Date | 2007-08-13 |
Last Update Date | 2007-08-13 |