| NPI | 1851704571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: NY 531717) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: NC 174072) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2014-06-10 |