NPI | 1770289795 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 202002923RN) |
Additional Taxonomies | 163WR0400X Registered Nurse, Rehabilitation (Licence: OR 202002923RN) |
Enumeration Date | 2023-02-01 |
Last Update Date | 2023-02-01 |