| NPI | 1699301036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: LA RN152099) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN152099) |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2023-08-02 |