| NPI | 1255863817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA2000X Registered Nurse, Administrator (Licence: DC RN1055366) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: VA 0001236100) |
| 163WX0106X Registered Nurse, Occupational Health (Licence: DC RN1055366) | |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2023-10-31 |