| NPI | 1235604042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WI0600X Registered Nurse, Infection Control (Licence: TX 794082) |
| Additional Taxonomies | 163WI0600X Registered Nurse, Infection Control (Licence: NV RN79257) |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2018-10-08 |