| NPI | 1770879256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: MA 8154) |
| Additional Taxonomies | 171W00000X Contractor (Licence: MA 8154) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2022-07-21 |