| NPI | 1184286817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0400X Registered Nurse Case Management (Licence: PR 82480) |
| Additional Taxonomies | 163WC1500X Registered Nurse Community Health (Licence: PR 82480) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2019-07-02 |