| NPI | 1891110847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC HHA9545) |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2023-10-11 |