NPI | 1023239803 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: AZ 090455) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: AZ 410) |
Enumeration Date | 2007-05-01 |
Last Update Date | 2007-07-08 |