| NPI | 1689557506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: DC RN1015085) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: DC RN1015085) |
| Enumeration Date | 2025-07-29 |
| Last Update Date | 2025-08-05 |