| NPI | 1871849042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: TX 522482) |
| Additional Taxonomies | 163WP0000X Registered Nurse, Pain Management (Licence: TX 522482) |
| 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: TX 522482) | |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2012-07-25 |