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Individual
INI UDOH
Active
Individual
INI UDOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NA00603449
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA00603449
CERTIFIED NURSING ASSISTANT
DC
Enumeration date
10/18/2016
Last updated
10/18/2016
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