| NPI | 1285699934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: GA RN158379) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: GA RN158379) |
| 163W00000X Registered Nurse (Licence: GA RN158379) | |
| 163WH0200X Registered Nurse, Home Health (Licence: GA RN158379) | |
| 163WW0000X Registered Nurse, Wound Care (Licence: GA RN158379) | |
| 163WH0500X Registered Nurse, Hemodialysis (Licence: GA RN158379) | |
| 163WG0000X Registered Nurse, General Practice (Licence: GA RN158379) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2011-03-27 |