| 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 |