| NPI | 1508378159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: HHA13152) |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2023-07-25 |