| NPI | 1811554348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| 374U00000X Home Health Aide (Licence: DC HHA14466) | |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2024-10-03 |