| NPI | 1942077318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician Personal Care Attendant |
| Additional Taxonomies | 3747P1801X Technician Personal Care Attendant |
| Enumeration Date | 2023-12-06 |
| Last Update Date | 2023-12-06 |