NPI | 1427648849 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: AL 1-150282) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WY 38921) |
Enumeration Date | 2021-01-20 |
Last Update Date | 2021-01-20 |