| NPI | 1720054109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: FL RN3421082) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN3421082) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2023-05-01 |