| NPI | 1780014431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: NC 220666) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 220666) |
| Enumeration Date | 2013-11-16 |
| Last Update Date | 2013-11-16 |