| NPI | 1013441765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: FL RN9567705) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: FL RN9338240) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2021-08-16 |