| NPI | 1457563843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: ID N-34179) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: ID N-34179) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-05-06 |
| Last Update Date | 2007-07-08 |