| NPI | 1497502223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: PR 96785) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: PR 96785) |
| 163WI0500X Registered Nurse, Infusion Therapy (Licence: PR 96785) | |
| Enumeration Date | 2024-04-30 |
| Last Update Date | 2024-04-30 |