| NPI | 1750997763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: MD A00181719) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: MD A00181719) |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2020-09-16 |