NPI | 1235335217 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: DC RN1050317) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MD LP41126) |
374U00000X Home Health Aide (Licence: DC HHA8909) | |
Enumeration Date | 2007-06-26 |
Last Update Date | 2019-05-09 |