| NPI | 1891740320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: MN 332211) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: MN R069057-5) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2007-07-09 |