| NPI | 1912357500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide |
| Additional Taxonomies | 172A00000X Driver (Licence: OR 6275531) |
| 372500000X Chore Provider | |
| 372600000X Adult Companion | |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2016-06-15 |