| NPI | 1427875079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IL 041429730) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NV 847791) |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-24 |