| NPI | 1477987667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN9261502) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: FL RN9261502) |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: FL RN9261502) | |
| Enumeration Date | 2013-08-25 |
| Last Update Date | 2013-08-25 |