| NPI | 1508083015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP2201X Registered Nurse, Ambulatory Care (Licence: ND R29443) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: ND R29443) |
| 163WX0106X Registered Nurse, Occupational Health (Licence: ND R29443) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2025-09-11 |