NPI | 1871064220 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WS0200X Registered Nurse, School (Licence: CA 95149758) |
Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: IL 041459379) |
163WS0200X Registered Nurse, School (Licence: ME RN72054) | |
Enumeration Date | 2018-12-11 |
Last Update Date | 2018-12-11 |