| NPI | 1497254494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: NM RN-88313) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: FL RN9359925) |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2018-02-05 |