| NPI | 1780989814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: AK 9280) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: AK 9280) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2011-01-20 |