| NPI | 1275885584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: TN 18171) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 167088) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2014-01-28 |