| NPI | 1790086502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: SC 0066305) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: SC 0066305) |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2010-11-10 |