| NPI | 1770449647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0600X Registered Nurse, Gerontology (Licence: CT 126687) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: CT 126687) |
| 163WG0000X Registered Nurse, General Practice (Licence: CT 126687) | |
| 163WI0600X Registered Nurse, Infection Control (Licence: CT 126687) | |
| 163WR0400X Registered Nurse, Rehabilitation (Licence: CT 126687) | |
| Enumeration Date | 2026-01-05 |
| Last Update Date | 2026-01-05 |