| NPI | 1649931940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: TX 900933) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX 900933) |
| Enumeration Date | 2022-01-07 |
| Last Update Date | 2022-02-08 |