| NPI | 1699036657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: DC LPN1008492) |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2023-07-19 |