| NPI | 1790464949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant (Licence: PA 72283601) |
| Additional Taxonomies | 372600000X Adult Companion (Licence: PA 72283601) |
| 374U00000X Home Health Aide (Licence: PA 72283601) | |
| Enumeration Date | 2023-07-14 |
| Last Update Date | 2024-10-18 |