| NPI | 1841792058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: IL 4000571) |
| Additional Taxonomies | 376J00000X Homemaker (Licence: IL 3001619) |
| Enumeration Date | 2018-03-03 |
| Last Update Date | 2018-03-03 |