| NPI | 1750565362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant (Licence: MN 97694) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: MN 97694) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2007-12-19 |