| NPI | 1598639015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: VA 0001304977) |
| Additional Taxonomies | 372600000X Adult Companion (Licence: VA 0001304977) |
| 163WP0000X Registered Nurse, Pain Management (Licence: VA 0001304977) | |
| 163WW0000X Registered Nurse, Wound Care (Licence: VA 0001304977) | |
| Enumeration Date | 2025-09-30 |
| Last Update Date | 2025-09-30 |