| NPI | 1508237553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NC 146574) |
| Additional Taxonomies | 163WC1600X Registered Nurse Continuing Education/Staff Development (Licence: NC 146574) |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2015-10-16 |