| NPI | 1437848728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse Home Health (Licence: MN R193717-2) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: MN R193717-2) |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2023-05-03 |