NPI | 1659762540 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: FL RN 2616882) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN 175252) |
163WC0400X Registered Nurse, Case Management (Licence: CA RN 3381909) | |
Enumeration Date | 2015-02-12 |
Last Update Date | 2015-02-12 |