| NPI | 1821558883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: NV 821347) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NV OT-2230) |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2024-03-06 |