| NPI | 1710331046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: DC HHA11965) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: DC NA00607852) |
| 376K00000X Nurse's Aide (Licence: MD A00158178) | |
| Enumeration Date | 2016-04-23 |
| Last Update Date | 2016-04-23 |