| NPI | 1699200899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CO RN.1644956) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200942181RN) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2017-04-25 |