| NPI | 1821544818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: DC RN1028482) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DC RN1028482) |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: MD R203641) | |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2016-08-30 |