| NPI | 1093776999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: WI 150051-030) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: WI 150051-030) |
| 163WS0200X Registered Nurse, School (Licence: WI 150051-030) | |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2007-07-09 |