| NPI | 1982046025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse Home Health (Licence: PR 35403 G) |
| Additional Taxonomies | 163WC0400X Registered Nurse Case Management (Licence: PR 35403 G) |
| 163WC3500X Registered Nurse Cardiac Rehabilitation (Licence: PR 35403 G) | |
| 163WI0500X Registered Nurse Infusion Therapy (Licence: PR 35403 G) | |
| 163WW0000X Registered Nurse Wound Care (Licence: PR 35403 G) | |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2013-07-17 |