| NPI | 1215746466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: NY 01003186) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 261QP0905X Clinic/Center, Public Health, State or Local | |
| Enumeration Date | 2025-01-02 |
| Last Update Date | 2025-05-29 |