| NPI | 1962915900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC HHA13016) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2024-03-15 |