| NPI | 1255731873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: GA RN137902) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: GA RN137908) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2014-09-02 |