| NPI | 1871481234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN9543801) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PR 38422) |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-06-25 |