| NPI | 1558708685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DC RY500002273) |
| 251S00000X | |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2024-06-20 |