| NPI | 1033626635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: DC LPN200002497) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 374U00000X Home Health Aide (Licence: DC HHA13466) | |
| 376K00000X Nurse's Aide (Licence: DC 256963753) | |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2023-08-14 |