| NPI | 1275285736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 610068) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: CA 610068) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 610068) | |
| 163WC0400X Registered Nurse, Case Management (Licence: CA 610068) | |
| 163WH0200X Registered Nurse, Home Health (Licence: CA 610068) | |
| 163WH1000X Registered Nurse, Hospice (Licence: CA 610068) | |
| 163WI0500X Registered Nurse, Infusion Therapy (Licence: CA 610068) | |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-01-25 |