| NPI | 1295235984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AZ RN205182) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95118046) |
| 163W00000X Registered Nurse (Licence: NM RN-85497) | |
| 163W00000X Registered Nurse (Licence: TX 884244) | |
| 163W00000X Registered Nurse (Licence: MA RN2320628) | |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2018-02-19 |