NPI | 1982035085 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NJ 26NP06968200) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 316327) |
Enumeration Date | 2013-11-28 |
Last Update Date | 2013-11-28 |