| NPI | 1376250431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: FL 9514804) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: FL 9514804) |
| 163WH0200X Registered Nurse, Home Health (Licence: FL 9514804) | |
| 163WH1000X Registered Nurse, Hospice (Licence: FL 9514804) | |
| 163WP0200X Registered Nurse, Pediatrics (Licence: FL 9514804) | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: FL 9514804) | |
| Enumeration Date | 2022-10-28 |
| Last Update Date | 2022-10-28 |