| NPI | 1689379885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: DC RN1060702) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: DC RN1060702) |
| 163WC0400X Registered Nurse, Case Management (Licence: DC RN1060702) | |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2023-04-05 |