| NPI | 1720653629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: TN 102279) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: TN 102279) |
| 163WC1500X Registered Nurse, Community Health (Licence: TN 102279) | |
| 163WH1000X Registered Nurse, Hospice (Licence: TN 102279) | |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: TN 102279) | |
| 163WN1003X Registered Nurse, Nutrition Support (Licence: TN 102279) | |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2021-05-24 |