| NPI | 1205643715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AZ RN139091) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 586439) |
| 163W00000X Registered Nurse (Licence: CT 148161) | |
| 163W00000X Registered Nurse (Licence: HI 79247) | |
| 163W00000X Registered Nurse (Licence: IL 41427272) | |
| 163W00000X Registered Nurse (Licence: MA RN2301841) | |
| 163W00000X Registered Nurse (Licence: MI 4704330095) | |
| 163W00000X Registered Nurse (Licence: MN 2245863) | |
| 163W00000X Registered Nurse (Licence: NV RN82331) | |
| 163W00000X Registered Nurse (Licence: NY 743284) | |
| Enumeration Date | 2024-12-17 |
| Last Update Date | 2024-12-17 |