| NPI | 1922890904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care (Licence: IL 041572103) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: IL 041572103) |
| 163WG0000X Registered Nurse, General Practice (Licence: IL 041572103) | |
| 163WI0500X Registered Nurse, Infusion Therapy (Licence: IL 041572103) | |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-08-12 |