| NPI | 1073705265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN2801682) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: FL 163WH0200X) |
| 372600000X Adult Companion (Licence: FL RN 2801682) | |
| 376K00000X Nurse's Aide (Licence: FL RN 2801682) | |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2007-08-13 |