| NPI | 1831721174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC 14770) |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2023-06-07 |