| NPI | 1659081057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: DC RN62539) |
| Additional Taxonomies | 251S00000X (Licence: DC RN62539) |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2023-06-05 |