NPI | 1225826654 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 10020111) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR RN) |
Enumeration Date | 2025-04-26 |
Last Update Date | 2025-04-26 |