| NPI | 1043025679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse Wound Care (Licence: NC 275140) |
| Additional Taxonomies | 163WC2100X Registered Nurse Continence Care (Licence: NC 275140) |
| 163WX1500X Registered Nurse Ostomy Care (Licence: NC 275140) | |
| Enumeration Date | 2025-02-11 |
| Last Update Date | 2025-02-11 |