| NPI | 1275945180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: NC 149246) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: GA RN238433) |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: CA 579317) | |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: NV trn308154) | |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: FL RN9204156) | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-05-27 |