NPI | 1740629187 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WE0003X Registered Nurse Emergency (Licence: MO 2003017737) |
Additional Taxonomies | 163WE0003X Registered Nurse Emergency (Licence: KS 14121954022) |
Enumeration Date | 2013-06-19 |
Last Update Date | 2013-06-19 |