| NPI | 1528807765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WI0500X Registered Nurse, Infusion Therapy (Licence: MN 2458941) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: MN 2458941) |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-05-20 |