| NPI | 1730953811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: PR 97796) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: PR 97796) |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2024-01-09 |