| NPI | 1366483653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: AZ RN107166) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ rn107166) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2019-08-27 |