NPI | 1821425653 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: DC RN59341) |
Additional Taxonomies | 208D00000X General Practice (Licence: MD D0052273) |
Enumeration Date | 2013-10-11 |
Last Update Date | 2013-10-11 |