| NPI | 1790660041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP2201X Registered Nurse, Ambulatory Care (Licence: AZ RN195012) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: AZ RN195012) |
| Enumeration Date | 2025-08-06 |
| Last Update Date | 2025-08-06 |