| NPI | 1619799178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: HI RN-78047) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 1110289) |
| 163W00000X Registered Nurse (Licence: CA 95074742) | |
| 163W00000X Registered Nurse (Licence: WA RN60566892) | |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2024-10-28 |