| NPI | 1033692827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: DC RN200005253) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC HHA13417) |
| Enumeration Date | 2018-09-08 |
| Last Update Date | 2024-02-19 |