| NPI | 1013749837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 818001) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: CA 818001) |
| 163WH1000X Registered Nurse, Hospice (Licence: CA 818001) | |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-08-19 |