| NPI | 1801685227 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: NV 838679) | 
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NV 838679) | 
| Enumeration Date | 2025-05-02 | 
| Last Update Date | 2025-05-05 |