| NPI | 1003217746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0400X Registered Nurse Case Management (Licence: GA RN109323) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN109323) |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2021-11-19 |