| NPI | 1821112053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: TN APN7013) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: TN RN101012) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-06-29 |