| NPI | 1871051128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care (Licence: PR 078971) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PR 075971) |
| 163WE0003X Registered Nurse, Emergency (Licence: PR 075971) | |
| 163WG0000X Registered Nurse, General Practice (Licence: PR 075971) | |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2019-06-11 |