NPI | 1508383654 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: CA 95078837) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CA 95078837) |
Enumeration Date | 2017-08-29 |
Last Update Date | 2018-03-17 |