| NPI | 1194974279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: IL 209.007104) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041317875) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2020-05-20 |