| NPI | 1801349204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: GA PHCP009529) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: GA PHCP009529) |
| 374U00000X Home Health Aide (Licence: GA PHCP009529) | |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2016-08-02 |