| NPI | 1548936412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WS0200X Registered Nurse, School (Licence: AZ 260285) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: AZ 682812) |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2021-08-19 |