| NPI | 1003473653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: DC RN500008419) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 374U00000X Home Health Aide (Licence: DC HHA14456) | |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2023-09-25 |