| NPI | 1033828074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NC 211352) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: NC HC6770) |
| Enumeration Date | 2022-11-18 |
| Last Update Date | 2025-09-26 |