| NPI | 1558768044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: UT 5898503-3102) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: NV RN46562) |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2014-11-26 |