If you are a Healthcare Professional interested in joining as a nuaxia Member, please enter your details below and the nuaxia Member Services Team will contact you within approximately one week.
Your contact details:
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First Name
Last Name
Preferred Email
Professional Email
Mobile Phone Number
Your location:
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Country
State / Province / Region
Your primary practice type:
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Clinic or Practice
Distribution Centre
Hospital - Academic
Hospital - Non-Academic
Laboratory
Office
Palliative Care
Retail Pharmacy
Your medical license number:
[for the National Registration Number we require e.g. USA - NPI, UK - GMC, France - numéro d'identification PP, Germany - lebenslange Arztnummer, Italy - UMC rilasciano, Spain - número exclusivo de facultativo)
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National Registration Number
Primary Specialty
Secondary Specialty
Year Qualified
Proof of medical license
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NA
NA