| NPI | 1881276723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 251S00000X |
| 374U00000X Home Health Aide (Licence: DC HHA200002045) | |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2024-01-05 |