| NPI | 1427450501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care (Licence: AZ AP7336) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP7336) |
| Enumeration Date | 2014-09-21 |
| Last Update Date | 2024-04-23 |