| NPI | 1376333831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: HI 120588) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: VA 0001305449) |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-05-08 |