| NPI | 1609246958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: DC 1030194) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: MD 210407) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2015-09-29 |