NPI | 1528575248 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: IL 041405733) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 893242) |
163W00000X Registered Nurse (Licence: GA RN273461) | |
Enumeration Date | 2018-01-03 |
Last Update Date | 2018-01-03 |