| NPI | 1386193464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: IL 041400848) |
| Additional Taxonomies | 374U00000X Home Health Aide |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2016-09-29 |