| NPI | 1740679380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 246RP1900X Technician, Pathology, Phlebotomy | |
| 372500000X Chore Provider | |
| 372600000X Adult Companion | |
| 376J00000X Homemaker | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2015-01-20 |