NPI | 1265979918 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 201609966RN) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NV RN83860) |
Enumeration Date | 2017-01-19 |
Last Update Date | 2017-01-19 |