NPI | 1871787986 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: AR R085088) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AR L48434) |
Enumeration Date | 2007-08-31 |
Last Update Date | 2017-04-25 |