| NPI | 1366168908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: MA CNA51397) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: NH EL10316) |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2022-10-17 |