| NPI | 1184037582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0000X Registered Nurse General Practice (Licence: FL RN9356397) |
| Additional Taxonomies | 163WI0500X Registered Nurse Infusion Therapy (Licence: FL RN 9356397) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |