| NPI | 1437304672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: FL RN9251926) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9251926) |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2019-01-25 |