| NPI | 1326239070 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: FL RN 9172784) | 
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: FL RN 9172784) | 
| 163WC1500X Registered Nurse, Community Health (Licence: FL RN 9172784) | |
| 163WI0500X Registered Nurse, Infusion Therapy (Licence: FL RN 9172784) | |
| 163WW0000X Registered Nurse, Wound Care (Licence: FL RN 9172784) | |
| Enumeration Date | 2007-08-07 | 
| Last Update Date | 2023-12-26 |