| NPI | 1336608595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: MS 863311) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: MS 863311) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2019-03-18 |