| NPI | 1841053923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: FL RN9638337) |
| Additional Taxonomies | 376G00000X Nursing Home Administrator (Licence: FL RN9638337) |
| Enumeration Date | 2024-02-01 |
| Last Update Date | 2024-02-01 |