| NPI | 1376174151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: TX RN.0199833) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: CO RN.0199833) |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2021-07-12 |