| NPI | 1174623417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: FL RN9243437) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 305449) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2008-05-13 |