| NPI | 1194295170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: HI 2603) |
| Additional Taxonomies | 163WR0400X Registered Nurse, Rehabilitation (Licence: GA RN282157) |
| 163WR0400X Registered Nurse, Rehabilitation (Licence: HI 92269) | |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2019-01-29 |