NPI | 1306434170 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA 233649) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MA 233649) |
Enumeration Date | 2021-01-06 |
Last Update Date | 2021-01-06 |