| NPI | 1659907418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: IL 209.018331) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.458038) |
| 163W00000X Registered Nurse (Licence: MO 149788) | |
| 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: MO 149788) | |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2020-03-12 |