| NPI | 1063244986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251J00000X Nursing Care (Licence: UT 5275148-3102) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AZ 315677) |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-10-17 |