| NPI | 1679351936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0600X Registered Nurse Gerontology (Licence: PA RN6910899) |
| Additional Taxonomies | 163WC0400X Registered Nurse Case Management (Licence: KY 4031876) |
| 163WC0400X Registered Nurse Case Management (Licence: PA RN6910899) | |
| 163WH1000X Registered Nurse Hospice (Licence: PA RN6910899) | |
| 163WC3500X Registered Nurse Cardiac Rehabilitation (Licence: PA RN6910899) | |
| 163WH1000X Registered Nurse Hospice (Licence: KY 4031876) | |
| 163WP0000X Registered Nurse Pain Management (Licence: PA RN6910899) | |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2025-06-21 |