| NPI | 1508358086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC HHA13708) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2023-08-22 |