| NPI | 1699356931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CO RN.1676011) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2020002197) |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2021-07-26 |