| NPI | 1801000310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: MN R 155578-7) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 155578-7) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2007-07-08 |