| NPI | 1831429505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse Home Health (Licence: FL RN9206609) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9206609) |
| 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: FL RN9206609) | |
| Enumeration Date | 2010-01-02 |
| Last Update Date | 2010-01-02 |