| NPI | 1063025062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MS 890892) |
| Additional Taxonomies | 376J00000X Homemaker |
| 385H00000X Respite Care | |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-08-28 |