| NPI | 1770842379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 1041S0200X Social Worker, School |
| 374U00000X Home Health Aide (Licence: DC 2966135) | |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2024-09-25 |