| NPI | 1043803703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: FL 9630542) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9630542) |
| 163WC1500X Registered Nurse, Community Health (Licence: FL 9630542) | |
| 163WL0100X Registered Nurse, Lactation Consultant (Licence: FL 9630542) | |
| 163WN1003X Registered Nurse, Nutrition Support (Licence: FL 9630542) | |
| 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: FL 9630542) | |
| Enumeration Date | 2021-02-14 |
| Last Update Date | 2024-06-07 |