| NPI | 1659347219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: LA RN087328) |
| Additional Taxonomies | 367A00000X Advanced Practice Midwife (Licence: LA RN087328) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2007-07-08 |