| NPI | 1497785026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: PA VP003361B) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: PA RN310230L) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2014-08-21 |