| NPI | 1962512681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: IN 70000144) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28124380) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-11-29 |