| NPI | 1568242659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC1600X Registered Nurse, Continuing Education/Staff Development (Licence: KY 1159765) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: IL 041442571) |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2023-10-05 |