| NPI | 1316765712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: DC HHH200004239) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC 200004239) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2024-10-03 |
| Last Update Date | 2025-05-14 |