| NPI | 1841496536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0500X Registered Nurse, Hemodialysis (Licence: KY 1031698) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: KY 1031698) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2025-09-11 |