| 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 |