| NPI | 1073757472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: GA 016287) |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: GA 016287) |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2023-03-07 |