| NPI | 1679884092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WX0200X Registered Nurse, Oncology (Licence: AK 25652) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 234760) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2010-06-30 |