NPI | 1114638046 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WP2201X Registered Nurse, Ambulatory Care (Licence: CA 95155205) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95155205) |
163WA2000X Registered Nurse, Administrator (Licence: CA 95155205) | |
163WH0500X Registered Nurse, Hemodialysis (Licence: CA 95155205) | |
Enumeration Date | 2022-12-12 |
Last Update Date | 2022-12-12 |