| NPI | 1457994675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: PR 78513) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: PR 78513) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2019-10-21 |