NPI | 1275030843 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA VN216427) |
Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 216427) |
Enumeration Date | 2018-04-10 |
Last Update Date | 2018-04-10 |