| NPI | 1720408685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 372600000X Adult Companion (Licence: CA 892204) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: CA 892204) |
| 376K00000X Nurse's Aide (Licence: CA 892204) | |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2014-04-18 |