| NPI | 1316551518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: MN 636) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: MN 2453118) |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2023-12-15 |