| NPI | 1821753765 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: DC RN1039623)  | 
| Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: DC RN1039623)  | 
| 374U00000X Home Health Aide (Licence: MD R219761)  | |
| 364SH0200X Clinical Nurse Specialist, Home Health (Licence: MD R219761)  | |
| 253Z00000X In Home Supportive Care (Licence: DC RN1039623)  | |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: DC RN1039623)  | |
| 163WH0200X Registered Nurse, Home Health (Licence: MD R219761)  | |
| Enumeration Date | 2021-11-05 | 
| Last Update Date | 2025-10-21 |