| NPI | 1033511753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: DC LPN 1007809) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: DC LPN 1007809) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-09-25 |