| NPI | 1558871053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: CA 789398) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: CA 789398) |
| 163WH1000X Registered Nurse, Hospice (Licence: CA 789398) | |
| 163WI0500X Registered Nurse, Infusion Therapy (Licence: CA 789398) | |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2017-10-10 |