| NPI | 1497444160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP2201X Registered Nurse, Ambulatory Care (Licence: FL RN9574990) |
| Additional Taxonomies | 163WX0800X Registered Nurse, Orthopedic (Licence: FL RN9574990) |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-05-08 |