| NPI | 1518204171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 251E00000X Home Health (Licence: DC 252441650790) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2024-12-11 |