| NPI | 1093240335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: FL 9600544) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TX 336043) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2022-09-02 |