| NPI | 1871005462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 372600000X Adult Companion (Licence: VA B509848) |
| Additional Taxonomies | 374T00000X Religious Nonmedical Nursing Personnel (Licence: VA B509848) |
| 376J00000X Homemaker (Licence: VA B509848) | |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2022-08-03 |