NPI | 1689172785 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC HHA13419) |
Enumeration Date | 2018-01-24 |
Last Update Date | 2023-07-11 |