| NPI | 1003343559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: MD 12733) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2024-10-03 |