| NPI | 1407257835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: GA RN164780) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: GA RN164780) |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2021-11-18 |