| NPI | 1689018871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WA2000X Registered Nurse, Administrator (Licence: NY 349234) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: CA 816320) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2013-04-18 |