NPI | 1669860524 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MD LP45803) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: DC LPN1005478) |
Enumeration Date | 2014-12-30 |
Last Update Date | 2014-12-30 |