| NPI | 1891578449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse Home Health (Licence: NC 227166) |
| Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: NC 227166) |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2023-08-17 |