| NPI | 1891225751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: MN 377294) |
| Additional Taxonomies | 376J00000X Homemaker (Licence: MN 377294) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2022-07-21 |