| NPI | 1518207653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: FL RN9448937) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY 725572) |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: GA 13-153) | |
| Enumeration Date | 2013-02-27 |
| Last Update Date | 2019-10-06 |