| NPI | 1487823092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: CO 1630968) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 1630968) |
| 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: TX 687333) | |
| 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: CA 748850) | |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2021-06-25 |