| NPI | 1184810970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: IL 041-323569) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: IL 041323569) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2014-06-27 |