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Individual provider · Ambulatory Care Registered Nurse · Mountain View, CA

NPI

1982546107

Type

Individual (Type 1)

Primary specialty

Ambulatory Care Registered Nurse (Registered Nurse)

Specialty group

Nursing Service Providers

Taxonomy code

163WP2201X

License number

9237206 (FL)

Sex

Male

Sole proprietor

Yes

Enumerated

2026-04-07

Last updated

2026-04-07