| NPI | 1134227051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: RI PPNS00096) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: RI RN36797) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2009-09-28 |