NPI | 1922264555 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: RI LPN09901) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MA 68043) |
Enumeration Date | 2008-08-04 |
Last Update Date | 2008-08-04 |