| NPI | 1316208770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse Home Health (Licence: DC RN1059680) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: DC LPN1007593) |
| 164W00000X Licensed Practical Nurse (Licence: MD LP50856) | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2025-07-07 |