| NPI | 1427471093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MD R18213) |
| Additional Taxonomies | 374U00000X Home Health Aide |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2014-02-01 |
| Last Update Date | 2014-02-01 |