| NPI | 1750511283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC3500X Registered Nurse, Cardiac Rehabilitation (Licence: NC 218184) |
| Additional Taxonomies | 163WC3500X Registered Nurse, Cardiac Rehabilitation (Licence: OR 200941206RN) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2009-07-17 |