| NPI | 1104665546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: UT 13014860-3102) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: UT 13014860-3102) |
| Enumeration Date | 2024-05-24 |
| Last Update Date | 2024-05-24 |