NPI | 1407550825 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 374U00000X Home Health Aide |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
251S00000X Community/Behavioral Health | |
Enumeration Date | 2023-03-29 |
Last Update Date | 2025-08-29 |