| NPI | 1346682127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: DC HHA8995) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: DC LPN1005192) |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2016-05-18 |