| NPI | 1639793722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251F00000X Home Infusion |
| 163WH0200X Registered Nurse, Home Health (Licence: MA RN2306433) | |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2020-06-03 |