| NPI | 1811245335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WX0200X Registered Nurse, Oncology (Licence: NC 196632) |
| Additional Taxonomies | 163WI0500X Registered Nurse, Infusion Therapy (Licence: NC 196632) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2012-08-15 |