| NPI | 1659618908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DC NP1046573) |
| Additional Taxonomies | 374U00000X Home Health Aide |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2023-09-20 |