| NPI | 1811735335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: TX 748484) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: TX 748484) |
| 163WP2201X Registered Nurse, Ambulatory Care (Licence: TX 748484) | |
| Enumeration Date | 2024-07-18 |
| Last Update Date | 2024-07-18 |