| NPI | 1215521471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MD R132786) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: MD R132786) |
| 163WC1500X Registered Nurse, Community Health (Licence: MD R132786) | |
| 163WH0500X Registered Nurse, Hemodialysis (Licence: MD R132786) | |
| Enumeration Date | 2021-02-26 |
| Last Update Date | 2021-02-26 |