| NPI | 1821734856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: GA PHCP011562) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA PHCP011562) |
| 372600000X Adult Companion (Licence: GA PHCP011562) | |
| 163WA2000X Registered Nurse, Administrator (Licence: GA PHCP011562) | |
| 163WH0200X Registered Nurse, Home Health (Licence: GA PHCP011562) | |
| 163WP0200X Registered Nurse, Pediatrics (Licence: GA PHCP011562) | |
| 163WW0000X Registered Nurse, Wound Care (Licence: GA PHCP011562) | |
| 172A00000X Driver (Licence: GA PHCP011562) | |
| 374U00000X Home Health Aide (Licence: GA PHCP011562) | |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2022-05-11 |