| NPI | 1740087212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: TX 1123512) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 1123512) |
| 364S00000X Clinical Nurse Specialist (Licence: TX 1123512) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2025-03-03 |
| Last Update Date | 2025-09-29 |