| NPI | 1083351431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NV 849303) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: NV 849303) |
| 163WI0500X Registered Nurse, Infusion Therapy (Licence: NV 849303) | |
| Enumeration Date | 2022-05-17 |
| Last Update Date | 2023-12-19 |