| NPI | 1497978738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: GA 044-R-0038) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: GA 044-R-0038) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-09 |