| NPI | 1346229408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: TN RN000124952) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN000124952) |
| 163W00000X Registered Nurse (Licence: GA RN254833) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2021-11-18 |