| NPI | 1275649873 |
|---|---|
| Former Name | LAURIE JEAN NELSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SM0705X Clinical Nurse Specialist, Medical-Surgical (Licence: MN L0264862) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2007-07-11 |