| NPI | 1477836054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: MN CNS0425) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: MN r153901-7) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2017-09-08 |