| NPI | 1326202094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WX0003X Registered Nurse, Obstetric, Inpatient (Licence: MA 235967) |
| Additional Taxonomies | 163WX0003X Registered Nurse, Obstetric, Inpatient (Licence: AZ RN151513) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2008-07-11 |