| NPI | 1780927285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: PA TLPN007261) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA TLPN007261) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2013-04-03 |