| NPI | 1689287682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 104100000X Social Worker |
| 164W00000X Licensed Practical Nurse (Licence: GA LPN090245) | |
| 172V00000X Community Health Worker | |
| 372600000X Adult Companion | |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-08-28 |