| NPI | 1497496962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: DC HHA200001866) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2024-04-11 |