| NPI | 1831026483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: NC 623) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 361681) |
| Enumeration Date | 2026-05-07 |
| Last Update Date | 2026-06-02 |