| NPI | 1912334111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 372600000X Adult Companion |
| 3747A0650X Technician Attendant Care Provider | |
| 3747P1801X Technician Personal Care Attendant | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2013-10-02 |