| NPI | 1811327406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: DC 1811327406) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC 9033) |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2024-05-13 |