| NPI | 1427894898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IL 041557178) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN61068761) |
| Enumeration Date | 2024-07-05 |
| Last Update Date | 2024-07-05 |