| NPI | 1275941205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: NJ 26nr12373600) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2024-02-12 |