| NPI | 1629586912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: AZ RN143627) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: AZ RN143627) |
| 163WI0500X Registered Nurse, Infusion Therapy (Licence: AZ RN143627) | |
| 163WW0000X Registered Nurse, Wound Care (Licence: AZ RN143627) | |
| 163WX1500X Registered Nurse, Ostomy Care (Licence: AZ RN143627) | |
| Enumeration Date | 2018-01-20 |
| Last Update Date | 2018-01-20 |