| NPI | 1710577671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WI0500X Registered Nurse, Infusion Therapy (Licence: MS 876049) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MS 876049) |
| 163WP0200X Registered Nurse, Pediatrics (Licence: MS 876049) | |
| 163WP0218X Registered Nurse, Pediatric Oncology (Licence: MS 876049) | |
| Enumeration Date | 2021-01-24 |
| Last Update Date | 2021-02-01 |