| NPI | 1144100033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: DC HHA200005552) |
| Additional Taxonomies | 374U00000X Home Health Aide |
| Enumeration Date | 2025-09-03 |
| Last Update Date | 2026-03-26 |