| NPI | 1861980195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: FL APRN11025406) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: VA 0024188359) |
| 163W00000X Registered Nurse (Licence: FL RN9329674) | |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2025-08-07 |