| NPI | 1942682927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: DC HHA11403) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: DC NA00606129) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2015-06-25 |