| NPI | 1164714499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: MT RN15669) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MT RN15669) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2011-05-04 |