| NPI | 1407568785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QI0500X Clinic/Center, Infusion Therapy (Licence: CO 1661901) |
| Additional Taxonomies | 163WI0500X Registered Nurse, Infusion Therapy (Licence: CO 1661901) |
| 163WI0600X Registered Nurse, Infection Control (Licence: CO 1661901) | |
| 163WA2000X Registered Nurse, Administrator (Licence: CO 1661901) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CO 1661901) | |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2024-04-16 |