| NPI | 1841953429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: FL 9305807) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: FL 9305807) |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2021-10-20 |