| NPI | 1720459738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist Adult Health (Licence: NC 172262) |
| Additional Taxonomies | 364SG0600X Clinical Nurse Specialist Gerontology (Licence: NC 172262) |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2015-10-16 |