| NPI | 1669970752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC HHA13049) |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2023-06-15 |