| NPI | 1902781727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TN 273494) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95326004) |
| Enumeration Date | 2025-08-11 |
| Last Update Date | 2025-08-11 |