| NPI | 1659254274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376G00000X Nursing Home Administrator (Licence: MN 1737) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: MN 1737) |
| 376J00000X Homemaker (Licence: MN 1737) | |
| 364SL0600X Clinical Nurse Specialist, Long-Term Care (Licence: MN 1737) | |
| Enumeration Date | 2025-07-30 |
| Last Update Date | 2025-09-24 |