| NPI | 1932881455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: WA NC61179577) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: WA NC61179577) |
| Enumeration Date | 2023-08-03 |
| Last Update Date | 2025-01-28 |