| NPI | 1255625448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: OH RN.370128-) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: TX 678765) |
| Enumeration Date | 2011-06-05 |
| Last Update Date | 2011-06-05 |