| NPI | 1285259556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1500X Registered Nurse Community Health (Licence: OK 80874) |
| Additional Taxonomies | 163WC0400X Registered Nurse Case Management (Licence: OK 316306) |
| 171400000X (Licence: OK 5488) | |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2024-02-26 |