| NPI | 1306536503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: NM R63659) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: NM R63659) |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2023-05-10 |