| NPI | 1881087625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: DC HHA11135) |
| Additional Taxonomies | 172A00000X Driver (Licence: DC 3278081) |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2015-11-04 |