| NPI | 1568625507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: GA RN135905) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: GA RN135905) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2008-07-09 |