| NPI | 1568712859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: CO 185328) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: CA 774296) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2012-09-13 |