| NPI | 1992220941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: NJ 4229763) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 693684) |
| 163WW0000X Registered Nurse, Wound Care (Licence: FL 4244) | |
| Enumeration Date | 2017-08-11 |
| Last Update Date | 2022-07-21 |