| NPI | 1750938635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: NC 547) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 303322) |
| Enumeration Date | 2019-08-24 |
| Last Update Date | 2023-07-31 |