| NPI | 1124898036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: FL RN3399232) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: FL RN9596601) |
| Enumeration Date | 2024-01-03 |
| Last Update Date | 2024-01-03 |