| NPI | 1821753765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: DC RN1039623) |
| Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: DC RN1039623) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: DC RN1039623) | |
| Enumeration Date | 2021-11-05 |
| Last Update Date | 2022-01-31 |