| NPI | 1417789231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: DC HHA200003748) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: DC HHA200003748) |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-09-10 |