| NPI | 1154994192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC HHA200001338) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2024-02-13 |