| NPI | 1073926390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WX0106X Registered Nurse Occupational Health (Licence: AK NURR38294) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2019-05-08 |