| NPI | 1013464015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WS0200X Registered Nurse, School (Licence: DE L1-0039334) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0039334) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2016-09-07 |