| NPI | 1275422735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: NE 62889) |
| Additional Taxonomies | 372500000X Chore Provider |
| Enumeration Date | 2025-06-30 |
| Last Update Date | 2025-06-30 |