| NPI | 1861940033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: FL RN9506689) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PR 80626G) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2024-09-10 |