| NPI | 1588146740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: DE LV-0000126) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0048754) |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2018-11-20 |