| NPI | 1316181670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist Adult Health (Licence: AR A003118) |
| Additional Taxonomies | 163WH0200X Registered Nurse Home Health (Licence: AR A03118) |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2017-04-10 |