| NPI | 1912318478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: NC 464508) |
| Additional Taxonomies | 372600000X Adult Companion (Licence: NC 464508) |
| 3747A0650X Technician Attendant Care Provider (Licence: NC 464508) | |
| 3747P1801X Technician Personal Care Attendant (Licence: NC 464508) | |
| 374U00000X Home Health Aide (Licence: NC 464508) | |
| 376J00000X Homemaker (Licence: NC 464508) | |
| Enumeration Date | 2014-05-17 |
| Last Update Date | 2016-03-14 |