| NPI | 1922474527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: DC RN200004848) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 374U00000X Home Health Aide (Licence: DC HHA11431) | |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2023-08-01 |