| NPI | 1760137541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: MD CNA20220033) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: MD CNA20220033) |
| Enumeration Date | 2022-02-19 |
| Last Update Date | 2022-03-14 |