| NPI | 1497123400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: WI 169632-30) |
| Additional Taxonomies | 163WC1600X Registered Nurse, Continuing Education/Staff Development (Licence: WI 169632-30) |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2021-12-01 |