| NPI | 1447066220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 95395532) |
| Additional Taxonomies | 163WH0200X Registered Nurse Home Health (Licence: CA 95395532) |
| 163WH1000X Registered Nurse Hospice (Licence: CA 95395532) | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: CA 95395532) | |
| Enumeration Date | 2024-12-06 |
| Last Update Date | 2024-12-06 |