| NPI | 1750793311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: DC HHA9644) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: DC HHA9644) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |