| NPI | 1932502143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WI0500X Registered Nurse, Infusion Therapy (Licence: OR 200943192rn) |
| Additional Taxonomies | 163WI0500X Registered Nurse, Infusion Therapy (Licence: WA es00117753) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2014-10-01 |