| NPI | 1912784109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care (Licence: CO 0198077) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO 0198077) |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2023-09-11 |