| NPI | 1265760284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: AZ rn139696) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: CO 125349) |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2014-05-30 |