| NPI | 1457773426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: DC HHA9721) |
| Additional Taxonomies | 163WH0200X Registered Nurse Home Health (Licence: DC HHA9721) |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2018-03-09 |