| NPI | 1972369080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: HI RN-40783) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: HI RN-40783) |
| Enumeration Date | 2024-02-26 |
| Last Update Date | 2024-02-26 |