| NPI | 1336650282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: DC HHA13074) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: DC HHA13074) |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2018-03-19 |