| NPI | 1295777290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MN R 160600-5) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: MN R-160600-5) |
| 163WG0100X Registered Nurse, Gastroenterology (Licence: MN R-160600-5) | |
| 163WG0000X Registered Nurse, General Practice (Licence: MN R-160600-5) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2014-05-27 |