NPI | 1508322942 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC HHA13104) |
Enumeration Date | 2019-02-11 |
Last Update Date | 2024-09-20 |