| NPI | 1245926328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: OR RN00140693) |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2023-04-14 |