| NPI | 1962090779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1500X Registered Nurse Community Health (Licence: MD R159225) |
| Additional Taxonomies | 163WC1500X Registered Nurse Community Health (Licence: MD D21043260) |
| 163WH0200X Registered Nurse Home Health (Licence: MD R159225) | |
| 163WI0500X Registered Nurse Infusion Therapy (Licence: MD D21043260) | |
| 163WI0500X Registered Nurse Infusion Therapy (Licence: MD R159225) | |
| 163WW0000X Registered Nurse Wound Care (Licence: MD R159225) | |
| 372600000X Adult Companion (Licence: MD D21043260) | |
| 372600000X Adult Companion (Licence: MD R159225) | |
| 3747P1801X Technician Personal Care Attendant (Licence: MD D21043260) | |
| 3747P1801X Technician Personal Care Attendant (Licence: MD R159225) | |
| 374U00000X Home Health Aide (Licence: MD D21043260) | |
| 374U00000X Home Health Aide (Licence: MD R159225) | |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2021-01-25 |