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 |