| NPI | 1154382828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: OK R0034908) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: KS 74810) |
| 364SE0003X Clinical Nurse Specialist, Emergency (Licence: OK R0034808) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2012-11-02 |