| NPI | 1134972003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0500X Registered Nurse, Hemodialysis (Licence: MA RN2330522) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: MA RN2330522) |
| 163WH0200X Registered Nurse, Home Health (Licence: NH 093440-21) | |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2024-04-09 |