NPI | 1922650043 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 201905335RN) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2019-07-09 |
Last Update Date | 2019-07-19 |