| NPI | 1013744820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: PR 85590) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PR 2757) |
| Enumeration Date | 2024-09-16 |
| Last Update Date | 2024-09-16 |