| NPI | 1578301461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0400X Registered Nurse, Rehabilitation (Licence: AR 218478) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: AR 11221112610) |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2024-07-16 |