| NPI | 1043987993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1600X Registered Nurse, Continuing Education/Staff Development (Licence: OK R0124657) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: OK R0124657) |
| 163WP2201X Registered Nurse, Ambulatory Care (Licence: OK R0124657) | |
| 163W00000X Registered Nurse (Licence: OK R0124657) | |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2022-01-05 |