| NPI | 1841557139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: DC RN1040592) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: DC LPN1006897) |
| 251E00000X Home Health | |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2016-09-20 |