| NPI | 1861851420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: DC HHA11693) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: DC HHA11693) |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2018-09-18 |