| NPI | 1740656404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WX0106X Registered Nurse Occupational Health (Licence: NE 67780) |
| Additional Taxonomies | 163WC1500X Registered Nurse Community Health (Licence: NE 67780) |
| 163WM0705X Registered Nurse Medical-Surgical (Licence: NE 67780) | |
| 163WP0200X Registered Nurse Pediatrics (Licence: NE 67780) | |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2015-08-18 |