| NPI | 1528731213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: DC HHA200001602) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: CNA20212708) |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2025-10-14 |