| NPI | 1124407168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC HHA11293) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2024-03-29 |