| NPI | 1437138302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WM0705X Registered Nurse Medical-Surgical (Licence: IA 049407) |
| Additional Taxonomies | 163WM0705X Registered Nurse Medical-Surgical (Licence: IL 041322709) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2008-09-08 |