| NPI | 1245192616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care (Licence: IA 102480) |
| Additional Taxonomies | 163WE0900X Registered Nurse, Enterostomal Therapy (Licence: IA 102480) |
| 163WX1500X Registered Nurse, Ostomy Care (Licence: IA 102480) | |
| 163WC0400X Registered Nurse, Case Management (Licence: IA 102480) | |
| Enumeration Date | 2025-11-24 |
| Last Update Date | 2025-11-24 |