NPI | 1316298334 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 457087) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN098926) |
Enumeration Date | 2012-10-01 |
Last Update Date | 2012-10-01 |