| NPI | 1073173373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WN0800X Registered Nurse, Neuroscience (Licence: NC 234993) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: NC 234993) |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: FL RN9289278) | |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2019-06-18 |