| NPI | 1508519166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: DE L1-0069261) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: DE L1-0069261) |
| Enumeration Date | 2022-02-02 |
| Last Update Date | 2022-02-02 |