| NPI | 1457788515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WN0800X Registered Nurse Neuroscience (Licence: TN 157730) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 157730) |
| 163W00000X Registered Nurse (Licence: CA 722601) | |
| 163WM0705X Registered Nurse Medical-Surgical (Licence: TN 157730) | |
| 163WX0800X Registered Nurse Orthopedic (Licence: TN 157730) | |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2013-10-03 |