| NPI | 1326461567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 374U00000X Home Health Aide (Licence: MD K-510-627-792-427) | |
| Enumeration Date | 2014-01-23 |
| Last Update Date | 2023-06-07 |