| NPI | 1295135200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: IN 28183759A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN276533) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2023-09-07 |