NPI | 1760684443 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: DE L10031564) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 540403) |
Enumeration Date | 2007-06-04 |
Last Update Date | 2007-07-08 |