| NPI | 1841673670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: OR 201143536RN) |
| Additional Taxonomies | 163WP0000X Registered Nurse, Pain Management (Licence: OR 201143536RN) |
| 163WP2201X Registered Nurse, Ambulatory Care (Licence: OR 201143536RN) | |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2015-06-29 |