NPI | 1942575881 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: OR 094000338) |
Additional Taxonomies | 183500000X Pharmacist (Licence: OR 8139) |
Enumeration Date | 2012-03-10 |
Last Update Date | 2012-09-28 |