| NPI | 1437911096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WE0003X Registered Nurse Emergency (Licence: VA 0001264975) |
| Additional Taxonomies | 163WE0003X Registered Nurse Emergency (Licence: NY 669952-01) |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-01-29 |