| NPI | 1699367144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1600X Registered Nurse, Continuing Education/Staff Development (Licence: TX 920054) |
| Additional Taxonomies | 163WC1600X Registered Nurse, Continuing Education/Staff Development (Licence: CA 95175781) |
| 163WE0003X Registered Nurse, Emergency (Licence: MD R251538) | |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2023-01-14 |