| NPI | 1427765346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CA 95083983) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: CA 95083983) |
| 163WP0200X Registered Nurse, Pediatrics (Licence: CA 95083983) | |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2022-10-31 |