NPI | 1811214331 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN 9305740) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 626580-1) |
Enumeration Date | 2010-04-23 |
Last Update Date | 2010-04-23 |