| NPI | 1619767217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MD R256523) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: DC RN500013379) |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-05-08 |