| NPI | 1518471861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: LA 153916) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: LA 153916) |
| 163WC1500X Registered Nurse, Community Health (Licence: LA 153916) | |
| 163WD1100X Registered Nurse, Dialysis, Peritoneal (Licence: LA 153916) | |
| 163WH1000X Registered Nurse, Hospice (Licence: LA 153916) | |
| 246RP1900X Technician, Pathology, Phlebotomy | |
| Enumeration Date | 2017-11-23 |
| Last Update Date | 2020-12-09 |