| NPI | 1346227154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WI0600X Registered Nurse, Infection Control (Licence: TX 676029) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN059793) |
| 163W00000X Registered Nurse (Licence: CA 283324) | |
| 163W00000X Registered Nurse (Licence: CA PHN25840) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2013-12-04 |