| NPI | 1386346096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: DC HHA200003427) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2025-09-16 |