| NPI | 1932986387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WS0200X Registered Nurse, School (Licence: NM 68671) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: NM 421211) |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2023-09-11 |