| NPI | 1811169881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 499223) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN-091807) |
| 163W00000X Registered Nurse (Licence: FL RN-9173060) | |
| 163W00000X Registered Nurse (Licence: VA RN-0001158222) | |
| 163W00000X Registered Nurse (Licence: WA RN-00147609) | |
| Enumeration Date | 2008-03-30 |
| Last Update Date | 2008-10-19 |