| NPI | 1780477356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: MD 10273589814) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: MD 10273589814) |
| Enumeration Date | 2025-05-27 |
| Last Update Date | 2026-05-05 |