| NPI | 1639536998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: AL 1-097977) |
| Additional Taxonomies | 163WW0000X Registered Nurse Wound Care (Licence: AL 1-097977) |
| Enumeration Date | 2016-01-18 |
| Last Update Date | 2016-01-18 |