NPI | 1609377936 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA VN236073) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2018-02-22 |
Last Update Date | 2018-03-17 |