| NPI | 1225847627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN 2478274) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 1030110) |
| 163W00000X Registered Nurse (Licence: FL RN9568124) | |
| Enumeration Date | 2025-01-01 |
| Last Update Date | 2025-01-01 |