| NPI | 1427562123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: MO 2013025569) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: MO 2013025569) |
| Enumeration Date | 2017-11-17 |
| Last Update Date | 2023-05-18 |