| NPI | 1891189767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: MS 06023302) |
| Additional Taxonomies | 376J00000X Homemaker (Licence: MS 05671361) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2015-03-30 |