| NPI | 1336963529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: MD A00217318) |
| Enumeration Date | 2024-11-13 |
| Last Update Date | 2025-10-08 |