| NPI | 1245579291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: FL RN9205521) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: NY 566897) |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2013-02-12 |