NPI | 1023737921 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN 2495972) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 266264) |
Enumeration Date | 2022-08-24 |
Last Update Date | 2022-08-24 |