| NPI | 1871357145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: NV RN66012) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: AZ 274706) |
| 163WH0200X Registered Nurse, Home Health (Licence: UT 11199674-3102) | |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2024-02-07 |