| NPI | 1659761484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: DC HHA9135) |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2018-03-06 |