| NPI | 1902584295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: VA 0001307166) |
| 164W00000X Licensed Practical Nurse (Licence: VA 0002094523) | |
| 372600000X Adult Companion | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2023-07-07 |
| Last Update Date | 2023-07-07 |