| NPI | 1679322044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: HI RN-62360) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: HI RN-62360) |
| Enumeration Date | 2024-05-16 |
| Last Update Date | 2024-05-21 |