| NPI | 1215619390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: IL 041306313) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041306313) |
| 163WX0800X Registered Nurse, Orthopedic (Licence: IL 041306313) | |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2023-08-07 |