| NPI | 1598500696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: MD R254935) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: DC RN500003248) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: DC RN500003248) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD R254935) | |
| Enumeration Date | 2024-06-28 |
| Last Update Date | 2024-06-28 |