NPI | 1285995118 |
---|---|
Other Name | SHAWN SMALLS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: DE L2-0010853) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN278828) |
Enumeration Date | 2012-06-07 |
Last Update Date | 2013-11-01 |