| NPI | 1831520758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| 363L00000X Nurse Practitioner (Licence: TN 36697) | |
| 363L00000X Nurse Practitioner (Licence: CA 95030734) | |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2024-07-17 |