| NPI | 1639417355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 372600000X Adult Companion |
| Additional Taxonomies | 163WC0400X Registered Nurse Case Management (Licence: GA RN188675) |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2013-01-30 |