| NPI | 1447617659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: MA 2291000) |
| 163WP2201X Registered Nurse, Ambulatory Care (Licence: MA 2291000) | |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2025-04-26 |