| NPI | 1093072308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: DC LPN1009029) |
| Additional Taxonomies | 251E00000X Home Health |
| 374U00000X Home Health Aide (Licence: DC HHA0909) | |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2024-02-21 |