| NPI | 1578228441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC HHA200001518) |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2023-08-01 |