| NPI | 1235163114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: GA 023424) |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: GA 023424) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-09-02 |