| NPI | 1528167673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: TX 578506) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 578506) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2023-05-13 |