| NPI | 1295613446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: SC 270559) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: SC 270559) |
| Enumeration Date | 2025-08-25 |
| Last Update Date | 2025-08-26 |