| NPI | 1780204487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: MA 2311123) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: MA 2311123) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2020-04-22 |