| NPI | 1962877944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WM0705X Registered Nurse Medical-Surgical (Licence: TN RN0000109271) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: TN RN0000109271) |
| 163WG0000X Registered Nurse General Practice (Licence: TN RN0000109271) | |
| 163WG0100X Registered Nurse Gastroenterology (Licence: TN RN0000109271) | |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2015-12-02 |