NPI | 1083120448 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: FL RN9474735) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9474735) |
163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: FL RN9474735) | |
163WG0000X Registered Nurse, General Practice (Licence: FL RN9474735) | |
163WI0500X Registered Nurse, Infusion Therapy (Licence: FL RN9474735) | |
Enumeration Date | 2017-12-21 |
Last Update Date | 2017-12-21 |