| NPI | 1972328474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA RN2350764) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NH 091369-21) |
| Enumeration Date | 2024-11-19 |
| Last Update Date | 2024-11-19 |