| NPI | 1720760622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251J00000X Nursing Care (Licence: SC 87797) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: SC 87797) |
| 163W00000X Registered Nurse (Licence: SC 87797) | |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2023-08-01 |