| NPI | 1407737414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: NM 82034) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM 82034) |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: NM 82034) | |
| 163WA2000X Registered Nurse, Administrator (Licence: NM 82034) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NM 82034) | |
| 163WC1500X Registered Nurse, Community Health (Licence: NM 82034) | |
| 163WH0200X Registered Nurse, Home Health (Licence: NM 82034) | |
| 163WI0500X Registered Nurse, Infusion Therapy (Licence: NM 82034) | |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: NM 82034) | |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NM 82034) | |
| 163WW0000X Registered Nurse, Wound Care (Licence: NM 82034) | |
| Enumeration Date | 2025-09-09 |
| Last Update Date | 2025-09-09 |