| NPI | 1528450905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: MD R3664) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: MD R3664) |
| 374U00000X Home Health Aide (Licence: MD R3664) | |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2015-02-23 |