NPI | 1356670020 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH 118682) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: DC LPN1008767) |
Enumeration Date | 2009-12-09 |
Last Update Date | 2023-04-13 |