| NPI | 1477025690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NM RN-88717) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: NM RN-88717) |
| 163WD0400X Registered Nurse, Diabetes Educator (Licence: NM RN-88717) | |
| 163WG0000X Registered Nurse, General Practice (Licence: NM RN-88717) | |
| 163WP0000X Registered Nurse, Pain Management (Licence: NM RN-88717) | |
| 163WP0200X Registered Nurse, Pediatrics (Licence: NM RN-88717) | |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: NM RN-88717) | |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NM RN-88717) | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: NM RN-88717) | |
| 163WR0400X Registered Nurse, Rehabilitation (Licence: NM RN-88717) | |
| 163WW0000X Registered Nurse, Wound Care (Licence: NM RN-88717) | |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2018-12-28 |