| NPI | 1740084227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SL0600X Clinical Nurse Specialist Long-Term Care (Licence: MA LN1002324) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist Adult Health (Licence: MA LN1002324) |
| 364SG0600X Clinical Nurse Specialist Gerontology (Licence: MA LN1002324) | |
| 364SH0200X Clinical Nurse Specialist Home Health (Licence: MA LN1002324) | |
| Enumeration Date | 2025-04-03 |
| Last Update Date | 2025-04-03 |