| NPI | 1750106860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: SC 256758) |
| Additional Taxonomies | 163WH1000X Registered Nurse, Hospice (Licence: SC 256758) |
| Enumeration Date | 2024-11-22 |
| Last Update Date | 2024-11-22 |