| NPI | 1063730950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 737311) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: HI RN-64546) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2010-05-17 |