| NPI | 1508601634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA2000X Registered Nurse Administrator (Licence: TN 255632) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 255632) |
| 163WC0200X Registered Nurse Critical Care Medicine (Licence: TN 255632) | |
| 163WN0002X Registered Nurse Neonatal Intensive Care (Licence: TN 255632) | |
| 163WN0003X Registered Nurse Neonatal, Low-Risk (Licence: TN 255632) | |
| 163WP0200X Registered Nurse Pediatrics (Licence: TN 255632) | |
| 163WP0218X Registered Nurse Pediatric Oncology (Licence: TN 255632) | |
| 163WP0807X Registered Nurse Psychiatric/Mental Health, Child & Adolescent (Licence: TN 255632) | |
| 376G00000X Nursing Home Administrator (Licence: MT NHA-NHA-LIC-6721) | |
| Enumeration Date | 2024-06-29 |
| Last Update Date | 2025-06-12 |