NPI | 1407836521 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA 127743) |
Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: MA 127743) |
Enumeration Date | 2006-01-17 |
Last Update Date | 2007-07-08 |