| NPI | 1063482826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care (Licence: SC R 75417) |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: GA RN106195) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2007-07-08 |