| NPI | 1326586785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: TX 823805) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 823805) |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2021-10-01 |