| NPI | 1790467975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: GA RN320856) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: GA RN320856) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: GA RN320856) | |
| 163WH1000X Registered Nurse, Hospice (Licence: GA RN320856) | |
| 163WI0500X Registered Nurse, Infusion Therapy (Licence: GA RN320856) | |
| 163WP2201X Registered Nurse, Ambulatory Care (Licence: GA RN320856) | |
| 171M00000X Case Manager/Care Coordinator (Licence: GA RN320856) | |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2024-07-29 |