| NPI | 1437492824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: DC 57918) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2024-07-03 |