| NPI | 1073321055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: VA 0001139257) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: VA 0001139257) |
| Enumeration Date | 2024-12-23 |
| Last Update Date | 2024-12-23 |