| NPI | 1760159347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 372600000X Adult Companion |
| 376G00000X Nursing Home Administrator | |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2021-08-23 |