| NPI | 1124780135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: DC HhA200001408) |
| 163WS0200X Registered Nurse, School (Licence: DC HhA200001408) | |
| Enumeration Date | 2021-10-07 |
| Last Update Date | 2024-12-06 |