NPI | 1346607470 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN 229689-6) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN192194) |
Enumeration Date | 2016-01-20 |
Last Update Date | 2016-01-20 |