| NPI | 1821436288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: DC 4645) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: DC 4645) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2013-06-07 |