| NPI | 1093353633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP2201X Registered Nurse, Ambulatory Care (Licence: PR 17677) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: PR 76664) |
| 163WC1500X Registered Nurse, Community Health (Licence: PR 17677) | |
| Enumeration Date | 2019-12-13 |
| Last Update Date | 2020-04-16 |