| NPI | 1225335375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: CA 760356) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: NY 593904) |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2011-02-24 |