| NPI | 1124914692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: AR R107788) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AR R107788) |
| 163WC0400X Registered Nurse, Case Management (Licence: AR r107788) | |
| 163WI0500X Registered Nurse, Infusion Therapy (Licence: AR R107788) | |
| 163WP2201X Registered Nurse, Ambulatory Care (Licence: AR r107788) | |
| 163WW0000X Registered Nurse, Wound Care (Licence: AR r107788) | |
| 171M00000X Case Manager/Care Coordinator (Licence: AR r107788) | |
| Enumeration Date | 2025-06-13 |
| Last Update Date | 2025-06-13 |