| NPI | 1841018074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: ND 66744) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2024-09-27 |
| Last Update Date | 2024-09-27 |