| NPI | 1740817717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: GA RN285670) |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2020-03-26 |