| NPI | 1558067843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse Home Health (Licence: OH 500836) |
| Additional Taxonomies | 163WG0600X Registered Nurse Gerontology (Licence: OH 500836) |
| 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: OH 500836) | |
| 163WR0400X Registered Nurse Rehabilitation (Licence: OH 500836) | |
| Enumeration Date | 2023-02-07 |
| Last Update Date | 2023-02-07 |