| NPI | 1821327750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN 1023442) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC R 203859) |
| 163W00000X Registered Nurse (Licence: AK 29242) | |
| Enumeration Date | 2009-12-24 |
| Last Update Date | 2009-12-24 |