| NPI | 1033746680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA 239005) |
| Additional Taxonomies | 174H00000X Health Educator |
| 282NR1301X General Acute Care Hospital, Rural | |
| 314000000X Skilled Nursing Facility | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2020-03-24 |