| NPI | 1013365360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: IL 209.010006) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: IL 041.323524) |
| 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: IL 209.010006) | |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2016-05-27 |