| NPI | 1134763691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: CA 95184607) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: CA 95184607) |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2019-10-28 |