| NPI | 1689385395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 729404) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9640128) |
| 163W00000X Registered Nurse (Licence: CA 95167177) | |
| 163W00000X Registered Nurse (Licence: NV 852127) | |
| Enumeration Date | 2022-12-13 |
| Last Update Date | 2024-07-15 |