| NPI | 1356508246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WE0900X Registered Nurse, Enterostomal Therapy (Licence: MO 136779) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: MO 136779) |
| 163WW0000X Registered Nurse, Wound Care (Licence: MO 136779) | |
| 163WX1500X Registered Nurse, Ostomy Care (Licence: MO 136779) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2008-05-19 |