| NPI | 1568851236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: PA 05680501) |
| Additional Taxonomies | 163WH1000X Registered Nurse, Hospice (Licence: PA 05680501) |
| 164W00000X Licensed Practical Nurse (Licence: PA 05680501) | |
| 374U00000X Home Health Aide (Licence: PA 05680501) | |
| Enumeration Date | 2015-01-17 |
| Last Update Date | 2015-01-17 |