| NPI | 1598577462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: RI RN62213) |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: RI RN62213) |
| Enumeration Date | 2025-01-27 |
| Last Update Date | 2026-02-07 |