| NPI | 1588341200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WA2000X Registered Nurse, Administrator (Licence: AZ RN144618) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: AZ RN144618) |
| Enumeration Date | 2023-07-04 |
| Last Update Date | 2023-07-04 |