| NPI | 1679234041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: FL RN9248794) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: FL RN9248794) |
| 163WP0000X Registered Nurse Pain Management (Licence: FL RN9248794) | |
| Enumeration Date | 2022-01-06 |
| Last Update Date | 2022-01-06 |