| NPI | 1841802121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH1000X Registered Nurse, Hospice (Licence: MI 4704339921) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704339921) |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2020-08-21 |