| NPI | 1366532699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: ME R020505) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: CT E36889) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2014-12-10 |