| NPI | 1689388282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: MI 4704187346) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: MI 4704187346) |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-01-09 |