| NPI | 1831472927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704221729) |
| Additional Taxonomies | 163WX0106X Registered Nurse, Occupational Health (Licence: MI 4704221729) |
| 163WX0106X Registered Nurse, Occupational Health (Licence: OH RN335752) | |
| Enumeration Date | 2011-09-24 |
| Last Update Date | 2021-09-02 |