NPI | 1073770251 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: NJ 26nr12315000) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA rn590730) |
Enumeration Date | 2008-05-16 |
Last Update Date | 2008-05-16 |