| NPI | 1437458510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WI0500X Registered Nurse, Infusion Therapy (Licence: CA 483766) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 483766) |
| 163WH0200X Registered Nurse, Home Health (Licence: CA 483766) | |
| Enumeration Date | 2011-03-15 |
| Last Update Date | 2011-03-15 |