| NPI | 1538196613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA2000X Registered Nurse, Administrator (Licence: FL RN9195891) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: FL RN9195891) |
| 225200000X Physical Therapy Assistant (Licence: FL PTA13106) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2007-07-08 |