| NPI | 1033530670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC HHA10212) |
| 376K00000X Nurse's Aide (Licence: DC 605752) | |
| Enumeration Date | 2013-12-29 |
| Last Update Date | 2026-03-17 |