| NPI | 1518120997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: MA 231123) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 231123) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2008-07-07 |