| NPI | 1881412419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA2000X Registered Nurse Administrator (Licence: NC 135175) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 135175) |
| 163WC0400X Registered Nurse Case Management (Licence: NC 135175) | |
| Enumeration Date | 2024-10-02 |
| Last Update Date | 2024-10-02 |