| NPI | 1225228919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: SC 79429) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 631050) |
| 163W00000X Registered Nurse (Licence: MA 257660) | |
| 163W00000X Registered Nurse (Licence: NH 052499-21) | |
| 163W00000X Registered Nurse (Licence: GA RN166152) | |
| 163W00000X Registered Nurse (Licence: AZ RN129654) | |
| Enumeration Date | 2007-07-28 |
| Last Update Date | 2007-07-28 |