NPI | 1851532972 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: DE L2-0008664) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN279333) |
Enumeration Date | 2009-03-19 |
Last Update Date | 2009-03-19 |