| NPI | 1629038443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care (Licence: VA 0101021693) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101-021693) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2022-08-19 |