| NPI | 1154985653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PR 777063) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PR 077063) |
| 163WH1000X Registered Nurse, Hospice (Licence: PR 077063) | |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2019-04-30 |