| NPI | 1215810593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TN 198030) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TN 198030) |
| 163WC1500X Registered Nurse, Community Health (Licence: TN 198030) | |
| 163WE0003X Registered Nurse, Emergency (Licence: TN 198030) | |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: TN 198030) | |
| Enumeration Date | 2025-07-25 |
| Last Update Date | 2025-07-25 |