NPI | 1851592760 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: PA TLPN003931) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: DE L2-009458) |
Enumeration Date | 2007-05-29 |
Last Update Date | 2007-07-08 |