| NPI | 1184638850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CO 112457) |
| Additional Taxonomies | 163WX0106X Registered Nurse, Occupational Health (Licence: CO 112457) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2007-07-08 |