| NPI | 1689064644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IL 041332410) |
| Additional Taxonomies | 163WC2100X Registered Nurse, Continence Care (Licence: IL 041332410) |
| 163WE0900X Registered Nurse, Enterostomal Therapy (Licence: IL 041332410) | |
| 163WH0200X Registered Nurse, Home Health (Licence: IL 041332410) | |
| 163WW0000X Registered Nurse, Wound Care (Licence: IL 041332410) | |
| 163WX1500X Registered Nurse, Ostomy Care (Licence: IL 041332410) | |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2015-01-29 |