| NPI | 1497030738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CO 99428) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2286093) |
| 163W00000X Registered Nurse (Licence: CA 821827) | |
| 163W00000X Registered Nurse (Licence: NY 665382-1) | |
| 163W00000X Registered Nurse (Licence: WA RN60344652) | |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2013-09-26 |