| NPI | 1134726227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: WI 125154-30) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: WI 11584-33) |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2025-01-21 |