| NPI | 1871083964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: HI APRN-2306) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: HI RN-76240) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2018-07-20 |