| NPI | 1962033662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: MD R224265) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: MD R224265) |
| 163WH0200X Registered Nurse, Home Health (Licence: MD R224265) | |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2020-01-31 |