| NPI | 1346507647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA2000X Registered Nurse, Administrator (Licence: FL RN1559152) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: FL RN1559152) |
| 163WR0400X Registered Nurse, Rehabilitation (Licence: FL RN1559152) | |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2012-04-12 |