| NPI | 1790878817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH1000X Registered Nurse, Hospice (Licence: MI 4704229857) |
| Additional Taxonomies | 163WH1000X Registered Nurse, Hospice (Licence: FL RN 9208843) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-09 |