| NPI | 1184061814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: DC RN1059726) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251E00000X Home Health | |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2023-07-20 |