| NPI | 1922422781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: MI 4704299258) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: MI 4704299258) |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2014-02-13 |